RT

名称：图1
描述：IMG_3788

名称：图2
描述：IMG_3782

名称：图3
描述：IMG_3783

名称：图4
描述：IMG_3784

名称：图5
描述：IMG_3785

名称：图6
描述：IMG_3786

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描述：IMG_3787

淋巴瘤？

滤泡间区膨胀性生长，结构还是破坏的，倾向淋巴瘤。

背景细胞较杂，血管增生，T可能性较大。

IHC鉴别

Beautiful slides.

The architecture of lymph node is partially affaced with marked interfollicular expansion and focal residual lymphoid follicles. The interfollicular areas consists of a mixed population of small lymphocytes, largers transformed lymphocytes, histiocytes/largerhans cells, eosinophils and high-endothelial venules. Overall, there is obvious morphologic evidence of lymphoma, but I totally agree with Dr. Arthus; basic immunostainis are necessary to rule out a T- or B-cell lymphoma. Other differential diagnosis also includes:

1). Infectious process. EBV, CMV or other virus.

2). Medication or vaccination.

3). Please do CD30 to rule out Hodgkin lymphoma or other sneakLy ALCL/PTCL.

4). Look carefully for myeloid sarcoma, which I think it is very unlikely in the case.

5). If all obove are ruled out, maybe consider doing IgG and IgG4 to rule out "IgG4 associated lymphadenopathy, paracortical expansion variant".

Beautiful slides.

The architecture of lymph node is partially affaced with marked interfollicular expansion and focal residual lymphoid follicles. The interfollicular areas consists of a mixed population of small lymphocytes, largers transformed lymphocytes, histiocytes/largerhans cells, eosinophils and high-endothelial venules. Overall, there is obvious morphologic evidence of lymphoma, but I totally agree with Dr. Arthus; basic immunostainis are necessary to rule out a T- or B-cell lymphoma. Other differential diagnosis also includes:

1). Infectious process. EBV, CMV or other virus.

2). Medication or vaccination.

3). Please do CD30 to rule out Hodgkin lymphoma or other sneakLy ALCL/PTCL.

4). Look carefully for myeloid sarcoma, which I think it is very unlikely in the case.

5). If all obove are ruled out, maybe consider doing IgG and IgG4 to rule out "IgG4 associated lymphadenopathy, paracortical expansion variant".

主要病变在滤泡间区，做四项基本标记(CD3/CD20/CD21/KI-67)后，如果滤泡间区是CD3细胞弥漫阳性，就补充CD2、CD5、CD7；如果是CD20弥漫阳性，就补充CD5、CD43。如果T细胞抗原有丢失就是T细胞淋巴瘤；如果B细胞有异常表达就是B细胞淋巴瘤；如果都没有就暂时诊断淋巴组织不典型增生，建议观察随访，必要时再取活检。